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    The alarm and action levels of waist circumference in overweight and obese Turkish women
    (Elsevier Sci Ltd, 2007) Tanyolac, Sinan; Cikim, Ayse Sertkaya; Azezli, Adil Dogan; Orhan, Yusuf
    Objective: To determine alarm and action levels' of waist circumference (WC) in overweight and obese Turkish women and investigate the relationship with cardiovascular risk factors. Research subjects and methods: Four thousand three hundred and seventy-five women aged 18-81 years selected from Istanbul Faculty of Medicine Obesity outpatient clinic. WC, waist-to-hip ratio (WHR), body mass index [(BMI) (weight (kg)/height (m(2)))], blood pressure, and biochemical parameters were analyzed. Results: There was strong correlation between BMI and WC levels (r: 0.852). The regression equation which describes this correlation [WC=1.68 x BMI (kg/m(2)) + 39.2 +/- 1.6] was applied to 500 random samples in order to define alarm and action levels for WC. Our results indicated that alarm level of WC at BMI 25 kg/m(2) is 81 cm and action level of WC at BMI 30kg/m(2) is 90cm. Validating samples were divided into three groups: group I (WC levels below 81 cm, n: 421), group 11 (WC levels between 81 and 90cm, n: 718), group III (WC Levels above 90cm, n: 2736) and further correlative analyses were performed. Strong differences within alarm and action groups in terms of cardiovascular risk factors were identified. The prevalence and mean values of cardiovascular risk factors significantly increased with WC. In group 1 one or more risk factor prevalence was 64.8%, whereas in groups 2 and 3 prevalence was increased to 76.8 and 89%, respectively. Conclusion: Turkish women with WC greater than 81 cm should gain no further weight and those greater than 90cm should reduce their weight. (c) 2007 Asian Oceanian Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.
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    Correlation between educational status and cardiovascular risk factors in an overweight and obese Turkish female population
    (Aves, 2008) Tanyolac, Sinan; Cikim, Ayse Sertkaya; Azezli, Adil Dogan; Orhan, Yusuf
    Objective: The prevalence of obesity is rapidly increasing in Turkey as well as all over the world. Educational inequalities play an important role in the development of obesity. In this study, our aim is to evaluate how educational status affects obesity and cardiovascular risk factors in the overweight and obese Turkish female population. Methods: In this study, 3080 overweight (n=633) and obese (n=2447) Turkish women who applied to Istanbul Faculty of Medicine Obesity Outpatient Clinic were evaluated retrospectively. Educational status was classified according to the subjects' latest term of education. Subjects were evaluated in terms of anthropometric and biochemical parameters. The association of educational level with cardiovascular risk factors and metabolic syndrome were analyzed using logistic regression analysis. Results: Educational levels after adjusted continuous variables (age and body mass index) showed significant correlation with waist circumference, total and high-density lipoprotein cholesterol, triglycerides, low-density lipoprotein cholesterol and glucose. Low educated class (LEC) had a 1.93 (95% CI - 1.56-2.39, p=0.001) fold increased risk than high educated subjects for cardiovascular risk factors. Metabolic syndrome prevalence was more prevalent and significant risk increase was observed in LEC (OR = 2.02, 95% CI -1.53-2.67, p=0.001). Conclusions: Low educational status is a contributing factor for development of obesity and increased risk for obesity related disorders in the Turkish overweight and obese female population. Population based information and educational policies might prevent obesity related disorders and decrease cardiovascular mortality. (Anadolu Kardiyol Derg 2008; 8: 336-41)
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    Diffusion-weighted imaging features of brain in obesity
    (Elsevier Science Inc, 2008) Alkan, Alpay; Sahin, Ibrahim; Keskin, Lezan; Cikim, Ayse Sertkaya; Karakas, Hakki Muammer; Sigirci, Ahmet; Erdem, Gulnur
    Purpose: Obesity is characterized by an altered distribution of body fluid. However, distribution of fluid (extracellular/intracellular) in brain tissues has not been studied in obese subjects yet. The purpose of this study was to detect possible brain diffusion changes especially in satiety and hunger related centers in obese subjects by diffusion weighted imaging (DWI). Methods: Conventional MRI and DWI of the brain was obtained from 81 obese patients (obese=68, morbid obese= 13) and 29 age-matched, nonobese. The apparent diffusion coefficient (ADC) values were calculated in hypothalamus; amygdala; hippocampal gyrus-1 thalamus; insula; cingulate gyrus; orbitofrontal, dorsomedial and dorsolateral frontal, middle temporal and occipital cortex; cerebellum; midbrain and corpus striatum. Results: The ADC values of hypothalamus, hippocampal gyrus, amygdala, insula, cerebellum and midbrain were significantly increased in patients (n:81) when compared to nonobese subjects. The ADC values of thalamus, hippocampal gyrus, amygdala, orbitofrontal, occipital, dorsolateral and middle temporal cortex, insula and midbrain were significantly increased in morbid obese when compared to nonobese subjects. The ADC values of orbitofrontal and occipital cortex were significantly higher in morbid obese than the values in the obese. The body mass index positively correlated with ADC values of amygdala, insula, orbitofrontal and middle temporal cortex. Conclusion: We observed increased ADC values of distinct locations related to satiety and hunger that suggest altered fluid distribution and/or vasogenic edema in obese subjects. Awareness of this abnormalities in brain tissue composition/function in obesity may contribute to better understanding of the underlying mechanisms. (0 2008 Elsevier Inc. All rights reserved.